Multiple myeloma (MM) is characterized by bone pain, pathologic fractures, bone destruction, and secondary hypercalcemia, all these conditions impact on health-related quality of life of patients. ...The objective was to evaluate the global health state and health-related quality of life in a group of patients with MM who attended a tertiary health-care center of the Instituto Mexicano del Seguro Social in Mexico, through the questionnaires designed by European Organization for Research and Treatment of Cancer (EORTC) quality of life group. Exploratory cross-sectional study in patients with MM treated in a Department of Hematology in a High-Specialty Medical Unit was conducted. Patients older than 18 years of age, men and women, were selected, and their informed written consent was obtained. We included all consecutive cases treated from January 2012 to December 2014. Questionnaires EORTC QLQ-C30, EORTC QLQ-MY20, and EORTC IN-PATSAT-32 were used. We studied 37 patients, 19 (51%) men and 18 women. The mean age was 61.9 years. Twenty-two (59.46%) patients presented with clinical stage III. The mean time for diagnosis was 33.11 months. The most used first-line treatment schedule was melphalan/prednisone/thalidomide (15; 40%). The global health median was 66.67, and symptoms showed a median score of 22.22. Treatment side effects score was 16.67; for general satisfaction, the median score was 75. In conclusion, the patients showed an advanced clinical stage and poor prognosis but had scores higher than 50 in functional scales and lower than 50 for symptom scales. The scores for symptom scales were related to age, renal failure, and disease-free survival. Identification of quality of life and satisfaction of care markers allow for early therapeutic intervention and efficiency and enable a change in quality of life and perception of care in Health Services.
Plant defense and adaptation to adverse environmental conditions rely on gene expression control, such as mRNA transcription, processing, stability, and translation. Sudden temperature changes are ...common in the era of global warming; thus, understanding plant acclimation responses at the molecular level becomes imperative. mRNA translation initiation regulation has a pivotal role in achieving the synthesis of the appropriate battery of proteins needed to cope with temperature stress. In this study, we analyzed the role of translation initiation factors belonging to the eIF4E family in Arabidopsis acclimation to cold temperatures and freezing tolerance. Using knockout (KO) and overexpressing mutants of
AteIF4E1
or
AteIF(iso)4E
, we found that AteIF4E1 but not AteIF(iso)4E overexpressing lines displayed enhanced tolerance to freezing without previous acclimation at 4°C. However, KO mutant lines,
eif(iso)4e-1
and
eif4e1-KO
, were more sensitive to the stress. Cold acclimation in wild-type plants was accompanied by increased levels of
eIF4E1
and
eIF(iso)4E
transcript levels, polysomes (P) enrichment, and shifts of these factors from translationally non-active to active fractions. Transcripts, previously found as candidates for eIF(iso)4E or eIF4E1 selective translation, changed their distribution in both P and total RNA in the presence of cold. Some of these transcripts changed their polysomal distribution in the mutant and one eIF4E1 overexpressing line. According to this, we propose a role of eIF4E1 and eIF(iso)4E in cold acclimation and freezing tolerance by regulating the expression of stress-related genes.
Abstract
Background
Tricuspid regurgitation (TR) is a prevalent valvular disease. Recent studies demonstrated that significant TR is associated with an increased mortality. However, information ...regarding the progression rate of TR is lacking, crucial for the correct clinical evaluation of such patients. Due to this fact, current guidelines fail to propose a scheduled follow-up programme in patients with significant TR; contrary to patients with left-sided valvular disease. The aim of this study is to examine the rates of TR progression and its clinical implications.
Objectives
To analyse the rate of progression of TR during follow-up and evaluate the impact of TR progression in hospitalizations due to heart failure (HF) or cardiovascular (CV) death.
Methods
1843 patients with at least moderate TR were prospectively followed up with consecutive echocardiographic studies and/or clinical evaluation. Clinical and echocardiographic features were recorded to assess their impact in TR progression. TR progression was defined as at least worsening of one grade according to Hahn and Zamorano classification based on Vena contracta width and effective regurgitant orifice area. The cumulative event rates were estimated with the Kaplan-Meyer method and compared by means of the log-rank test.
Results
Median follow-up time was 3.7 (IQR: 1.2 to 3.8) years. During the follow-up period, death occurred in 525 patients (28.5%); due to cardiovascular causes in 174 (9.4%) of them. Figure 1 shows the incidence of TR progression from moderate to at least severe TR during follow-up period. Moderate TR had 4.9%, 10.1% and 24.8% 1-year, 2-year and 3-year risk of progression to at least severe TR, respectively. The combined endpoint of cardiovascular mortality and hospitalization for heart failure was higher among progressors (23.5% vs. 37.7%; log rank P < 0.001, Figure 2).
Conclusions
Progression of TR is associated with an increased risk of hospitalizations and cardiovascular mortality. According to the rate of progression in our study, we support serial echocardiographic testing for these patients similar to that proposed by current guidelines for left-sided heart disease. However, we still need evidence of the impact of serial testing in TR.Incidence of TR progression from moderatKaplan Meier survival curves free from h
Background: Multiple sclerosis (MS) has a unique geographical distribution that reflects both genetic and environmental factors. Many studies have shown a positive correlation between MS frequency ...and latitude across both large and small geographical regions. However, scarce data have been published on the epidemiology of MS in Latin America and no study has evaluated latitudinal variation.
Objective: To evaluate the effect of latitude on MS prevalence in Latin America.
Methods: We conducted a systematic review of MS prevalence during January 2011. Prevalence rates were collected from eligible publications. The effect of latitude on prevalence was analyzed using linear regression.
Results: A total of ten studies were eligible for analysis, corresponding to six countries, spanning from Panama to Argentina. The crude prevalence of MS ranged from 0.75 to 21.5 per 100,000. We found a strong and significant association between prevalence and latitude (r2 0.8; p < 0.001) and determined an increase in prevalence of 0.33 per 100,000 per degree latitude.
Conclusion: Our findings suggest a latitudinal prevalence gradient of MS in Latin American countries between Panama and Argentina.
The ovarian function and therefore the ovarian reserve may be compromised by the pathogenesis of autoimmune diseases of which, Hashimoto's thyroiditis (HT) is the most common in women of reproductive ...age. Furthermore, a prolonged reduction in thyroid hormone concentration results in a broad spectrum of reproductive alteration. Previous reports in the literature have been controversial regarding the impact of hypothyroidism and alterations in the ovarian reserve. Thus, this prospective and comparative study aimed to evaluate the association of hypothyroidism with low ovarian reserve.
A subset of 27 patients with primary autoimmune hypothyroidism were compared to healthy women. The ovarian reserve was assessed through the anti-Mullerian hormone (AMH) and the antral follicle count (AFC).
Overall, the two groups did not display significant differences in length of their menstrual cycles neither in the AMH serum levels nor the AFC.
No significant alteration was found in the ovarian reserve of women with HT.
We present a new occultation event simulator for the Trans-Neptunian Automated Occultation Survey (TAOS II). We have developed a method to compute occultation shadows by small objects with ...non-circular apparent shapes (as may result from an intrinsic morphology or from the projection of a contact binary). The new simulator calculates diffraction features in the occultation shadows, as well as resulting light curves as would be measured by the TAOS II survey system. We include effects such as the spectral type and finite angular size of the occulted star. We find that occultation events, especially by Trans-Neptunian Objects with diameters ∼3 km may be misidentified or mischaracterized when not taking non-spherical shapes into account.
In the present study, quantitative real-time RT-PCR was used to monitor the transcriptional responses of seven key genes related to some innate immune pathways in shrimp postlarvae after being placed ...in a recirculating aquaculture system (RAS) with or without biofloc (BF or no-BF). Each system consisted of the main tank with 400 L of seawater and six glass aquariums (50 L each). Besides, the nucleotide sequences of myosin light chain (LvMyo) from
Litopenaeus vannamei
related to the phagocytosis pathway were described. The sequence analysis indicated that LvMyo is a conserved protein among crustaceans and is present in other arthropods. The transcriptional response to the treatments showed several expression patterns. The prophenoloxidase gene was up-regulated in both systems (
P
< 0.05) and was higher in BF than in no-BF (
P
< 0.01). Phagocytosis-related genes depicted differential expressions. LvMyo, Ras-associated binding 6, and Ras-related nuclear protein expressions were higher in BF than in no-BF (
P
< 0.05). Regarding antioxidant genes, glutathione peroxidase was up-regulated only in BF (
P
< 0.05). Superoxide dismutase expression was lower in BF at 12 h (
P
< 0.05), but higher at 24 h (
P
< 0.05). These findings suggest that biofloc modulates the transcription of genes related to the immune response in shrimp as an early response or at the mid-term. Besides, the biological filter in a RAS without biofloc seems to be able to maintain a bacterial population that promotes a lower but similar response to that induced in the biofloc system.
Abstract
Background and purpose
Dyslipidaemia is a significant risk factor for cardiovascular disease in the Mexican population. This analysis aims to describe the baseline LDL-c levels of patients ...at cardiovascular clinics and evaluate the proportion of them who achieved their risk-based LDL-c goals as recommended by 2021 ESC prevention guidelines.
Methods
The REMECAR registry is an observational study of patients attending a specialized cardiovascular clinic for their first visit. The cardiovascular risk was retrospectively determined using the 2021 ESC guideline stratification and the SCORE2 and SCORE-OP.
Results
A total of 5,443 patients were included in the analysis. Within this population, 55.96% presented as very high, 39.98% as high and 4.06% as moderate to low risk. 63% of the participants were not on any lipid lowering treatment at entry, while 12.4% were receiving high intensity statin therapy. Patients presenting with established atherosclerotic cardiovascular disease had a mean LDL-c of 90.9±40.7 mg/dL. Of these, 14.1% were achieving LDL-c levels of 70–50 mg/dL and 19.3% were achieving LDL-c levels <55mg/dL (Figure 1B) In diabetic patients at very high risk, only 25.7% reached their LDL-c goal. Finally, in patients without another risk factor and very high-risk evaluated by SCORE2 & SCORE-OP, only 14% of patients achieved their LDL-c goals.
Conclusions
A significant number of patients were not receiving lipid lowering therapy. Furthermore, in those who were, a significant portion did not achieve LDL-c recommended thresholds. Our results underline the urgent need to improve the prescription and optimisation of lipid lowering therapy as the current management appears to be insufficient for achieving optimal recommended goals. Identifying key barriers in lipid management is fundamental to establishing better strategies and health system policies to reduce cardiovascular risk.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AMGEN
El presente trabajo reporta la optimización de los parámetros de procesamiento de un recubrimiento base Ni. El efecto de tres variables de depósito, i.e., distancia de rociado, química de la flama y ...diámetro de la boquilla, fue evaluado sobre la estructura cristalina, porcentaje de porosidad, dureza y espesor del recubrimiento. El análisis se realizó en dos etapas, la primera consistió en determinar la influencia de la distancia de rociado sobre las características estructurales y microestructurales de los recubrimientos. En la segunda etapa se empleó un diseño de experimentos factorial 22 para evaluar el efecto del diámetro de la boquilla y la química de la flama sobre la porosidad, dureza y espesor del recubrimiento. Los resultados indicaron que la distancia de rociado afecta fuertemente la porosidad. A una distancia intermedia las partículas impactadas alcanzan un aplanamiento adecuado disminuyendo la porosidad, mientras que ésta última aumenta a distancias cortas y largas como resultado de la extensa o limitada deformación de las partículas al momento del impacto, respectivamente. De acuerdo a los resultados obtenidos del análisis del diámetro de la boquilla y la química de la flama, se observó que el primero tiene un efecto predominante en la microestructura y dureza de los recubrimientos. El uso de un diámetro pequeño de boquilla y una flama neutra reduce la porosidad e incrementa la dureza de los recubrimientos. Mediante la optimización de los parámetros se lograron obtener recubrimientos NiCrBSiMo con bajo contenido de porosidad y alto grado de dureza usando un proceso de rociado térmico de bajo costo.
Tendon transfers can be tied too tight or too loose. Both impede good function after surgery. Performing tendon transfers without sedation and pain during the surgery and then watching the patient ...move the transfer have helped us adjust the tension more accurately. This method can be applied to complex transfers such as radial nerve palsy triple tendon transfers. We describe the technique and results of a triple tendon transfer using wide-awake local anesthesia no tourniquet in a patient with a high radial nerve palsy. This was a complex case of reconstruction after five operations at the level of the humerus. This left him with a pseudoarthrosis of the humerus and a complete radial nerve palsy. We performed tendon transfers of pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to extensor pollicis longus tendons. Eighteen months after the triple tendon transfer surgery for the radial nerve palsy, the patient has good extension of the fingers, wrist, and thumb. He can open and close the hand properly. He has excellent function and mobility allowing him to perform most activities in a manner that is practically normal. Wide-awake local anesthesia no tourniquet can be used safely and successfully in complex cases requiring triple radial nerve tendon transfers of pronator teres to extensor carpi radialis brevis, flexor carpi ulnaris to extensor digitorum communis, and palmaris longus to extensor pollicis longus tendons.
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